Healthcare Provider Details
I. General information
NPI: 1831481670
Provider Name (Legal Business Name): LINDA GARCIA RRW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/12/2011
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1530 3RD ST SUITE 212
LINCOLN CA
95648-1562
US
IV. Provider business mailing address
406 SUNRISE AVE SUITE 310A
ROSEVILLE CA
95661-4106
US
V. Phone/Fax
- Phone: 916-434-8927
- Fax: 916-434-0678
- Phone: 916-797-8989
- Fax: 916-797-8979
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: